JAK Inhibitors for Treatment Gaps and Patient Care

In her session, “JAK in Dermatology,” presented at Dermatology Week 2022, Ruth Ann Vleugels, MD, MPH, MBA, discussed the role of JAK inhibitors to address treatment gaps and treatment pearls for integrating JAK inhibitors into patient care.

Dr Vleugels talked about her study published in 2016 about the use of JAK inhibitors for dermatomyositis wherein “all the patients had an improvement in itch and Cutaneous Dermatomyositis Disease Area and Severity Index score.”

Dr Vleugels explained, “The use of JAK inhibitors on dermatomyositis was also supported by a pilot trial of 10 patients that came out of Johns Hopkins in 2020.”

Next, she explained why some physicians have concerns about using JAK inhibitors. “Recent data has suggested that in the [rheumatoid arthritis] population, there’s an increased risk of major cardiovascular events in cancer.

She continued with some clinical pearls when JAK inhibitors are used:

• Many skin diseases warrant a higher dose, but adverse effects also need to be considered.
• It is safe to combine [a JAK inhibitor] with methotrexate.
• In terms of adverse events, consider a clear signal for zoster.

On the topic of JAK inhibitors used for psoriasis treatment, Dr Vleugels noted, “[The] FDA has not approved JAK inhibition for psoriasis; however, they have approved it for psoriatic arthritis.”

After highlighting various cases wherein JAK inhibitors were used for treatments, Dr Vleugels concluded her session with JAK inhibitors’ future expectations:

• JAK inhibitors may prove useful in an even wider array of recalcitrant skin diseases.
  • Only current FDA-approved dermatologic indication is atopic dermatitis.
• There is an increased clear signal for zoster and clotting risk, cardiac event risk, and cancer risk.

References:
Vleugels RA. JAK in dermatology. Presented at: Dermatology Week 2022; May 11-14, 2022; Virtual.